Why is Orthognathic Surgery Necessary?

The upper and lower jaws are bases upon which teeth and soft tissues are aligned.

Braces can only correct dental abnormalities like crooked teeth and poor bites. Disharmonies of jaw size or position can only be corrected surgically to achieve a good overall outcome.

Common problems that can be dealt with are:

• A protruded or retruded chin
• Excessive show of gums
• Overall elongation of face
• Facial asymmetry
• Post-traumatic facial injury and defect
• Obstructive Sleep Apnea
• Cleft lip/palate or other major craniofacial anomalies, as part of the comprehensive management plan

What are the Possible Causes of Jaw Abnormalities?

There are many causes of jaw discrepancies. They may be inherited or acquired from developmental or traumatic causes. Jaw discrepancies may affect not only your facial appearance but also your bite, speech and chewing.

Treatment is carried out in 4 phases:

Phase 1: Treatment Planning

Treatment planning is carried out jointly by an orthodontist and an oral and maxillofacial surgeon. The orthodontist sees how braces will align your teeth in preparation for surgery. The oral and maxillofacial surgeon studies your jaw deformity and decides on the type of surgery most appropriate for your case. Initial phase of treatment will include consultation, records-taking and discussion of the treatment plan with you.

Phase 2: Pre-surgical Orthodontic Phase

Many patients undergo an initial period of pre-surgical orthodontic treatment which may take 9 to 18 months. The actual time taken depends on the condition, the patient's age, cooperation and other factors. During this time, patients are seen at intervals of 4 to 6 weekly intervals.

Phase 3: Surgical Phase

Surgery is scheduled when the pre-surgical orthodontic phase is completed. Inpatient surgery is needed to correct the misalignment in the jaws and face by making cuts in the jaw bones and repositioning them in their desired alignment. Most patients can be discharged from the hospital after 1-3 days.

Phase 4: Post-surgical Orthodontic Phase

After surgery, post-surgical orthodontics is continued to achieve final alignment of the teeth and to retain them in their new position.

Can Surgery Be Avoided?

In growing patients, timely orthodontic intervention can sometimes correct jaw disharmonies. Special braces can then be used to modify bone growth, eliminating the need for surgery. However, for patients whose facial bones are no longer growing, certain corrections cannot be achieved with braces alone. A combined approach of braces and surgery is the appropriate form of treatment for such cases.

Are There Any Risks?

Orthognathic surgery is performed under general anaesthesia. It usually requires hospitalisation of about 1-3 days. Patients who undergo orthognathic surgery are generally healthy and therefore able to recover more easily.

Different conditions are corrected with varying procedures during orthognathic surgery. To set your mind at ease, simply ask your surgeons about the risks.

Are There Any Risks?

After the surgery, you will be prescribed medications to control pain and improve your recovery. Most patients are able to feed on liquid diet by mouth in the days immediately after the surgery. Your surgeons will walk you through your progress back to normal diet over the next few weeks during your regular visits. Proper oral hygiene care is crucial in preventing postoperative infections.